Health Committee on Dec. 7th, 2017

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

We've had an opportunity to discuss this one on one, and I'm happy that you bring up the question again today. We also have to recognize that the issue of the opioid crisis, as I've indicated in my earlier remarks, is quite devastating when you look at the numbers that are coming in right now. Again, with the report that came out from Ontario, it's very alarming to see the numbers that are coming up.

I have to say that our government certainly has taken steps so far in order to address the situation. When we formed government, one of the first bills that was brought forward was Bill C-37, a bill that really streamlined the application process to make sure that individuals had access to supervised consumption sites, and we recognized that saves lives.

Also with the issue of naloxone, we know that making sure that naloxone was a non-prescription type of medication that was available for people also saves lives. When the provinces and territories told us they were dealing with a targeted situation in their provinces, again, a specific funding was given to them. If you look at British Columbia, your province, they received an additional $10 million with respect to targeted funding and also, with respect to Alberta, they received some additional funding.

Just last month when I was in Calgary, we made some announcements. When we look at the Canadian youth substance abuse strategy that was put in place, we've also made some investments there as well to look at the issue. Again, when it comes to services that are on the ground, it's truly important to make sure that we continue to work with provinces and territories. The federal government absolutely has a role to play, and we certainly cannot be complacent when it comes to this crisis.

[Don Davies, NDP, Vancouver Kingsway, BC]

No, absolutely not.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

It is absolutely for me, as I say, as health minister, my number one priority, and when I say this situation keeps me up at night, it really does.

[Don Davies, NDP, Vancouver Kingsway, BC]

Minister, the question was asking you to contrast why the federal government spent triple the amount of money on H1N1 than today, and I didn't hear an answer to that, but I'm going to move to medicinal cannabis. My colleague brought this up.

From a health perspective, we know that medicinal cannabis is not zero rated. Already medicinal cannabis users have to pay GST and HST. We know that most prescription plans in this country don't cover medicinal cannabis, so already men and women who are struggling already have to pay extra money for medicinal cannabis.

Ironically, opioids are covered by most plans and are zero tax-rated exempt. Ironically, patients are incentivized to pursue a riskier option, and that's even compounded by the fact that studies are now showing that medicinal cannabis is proving very effective at helping people wean themselves off opioids. It's clearly a flawed policy to make medicinal cannabis more expensive than opioids.

I'm just wondering, at the cabinet table, Minister, would you advocate, from a health perspective, to at least treat medicinal cannabis the same as opioids.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

As the previous speaker indicated, with respect to tax policy, that's absolutely the Minister of Finance's area and the work that he is doing.

Again, next week the finance minister will be meeting with his territorial and provincial counterparts. I am certain this issue is going to be coming up. If the finance minister appears before the health committee, this would certainly be a question to be asked.

[Don Davies, NDP, Vancouver Kingsway, BC]

We know that the federal government covers the cost of medicinal cannabis for over 3,000 Canadian veterans. We heard testimony at this committee on September 14 from the first nations regional director Chief Isadore Day that the government does not cover the cost of medicinal cannabis for indigenous patients at all.

Can you explain that discriminatory policy to me?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

To be frank, Minister Philpott's department has been working on that. Perhaps I could ask my deputy minister to address this question.

[Don Davies, NDP, Vancouver Kingsway, BC]

Minister, if I may, I want to direct my questions to you. I think we'll have the staff staying after, and we can follow up then. We only have you for an hour or so. I'll just defer that, if that's okay.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Sure, absolutely.

[Don Davies, NDP, Vancouver Kingsway, BC]

I want to move to prescription drugs. I want to read a passage:

Prescription drugs.... Our current system provides full coverage for institutional care, including all drugs administered during a hospital stay. Once patients go home, however, they are not guaranteed public coverage for medically necessary drugs. Although some public coverage is provided for specific groups and situations, prescription drugs have yet to be fully incorporated into provincial health insurance schemes. Many Canadians have limited drug coverage through their employers, but a full 12 percent of Canadians have no coverage at all for prescription drugs. This situation is plainly inconsistent with the values upon which Canadian medicare is based. It is both unfair and illogical to guarantee access to medical diagnosis but not to the associated treatment. Neither does it make economic sense. Those who cannot afford to fill their prescriptions tend only to get sicker and require more costly treatment later from the public system.... Public coverage of medically necessary prescription drugs, as recommended by the National Forum on Health, would not only ensure universal access to treatment, it would also reduce the amount of money that Canadians are already spending on drugs....

[The Chair, Liberal, Bill Casey]

We need your question.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'll get to that, Mr. Chair.

These advantages include simplified administration, volume discounts for bulk purchasing, and improved monitoring of best practices in prescribing.... A new Liberal government will pursue a strategy—together with representatives—

[The Chair, Liberal, Bill Casey]

We need a question.

[Don Davies, NDP, Vancouver Kingsway, BC]

—of provincial and territorial governments, health service providers, private payers (employers and unions), and consumers—to address the fact that drugs have become an essential component of health care. We will develop with these groups a timetable and fiscal framework for the implementation of universal public coverage for medically necessary prescription drugs.

Minister, I'm reading to you from the Liberal platform in 1997, promised by Jean Chrétien. We've heard the PBO report. It's already been shown that we can cover every Canadian and save $4 billion a year.

I introduced a motion in the House of Commons asking your government to start discussions with the provinces in the next 12 months, and you called that proposal “premature”.

Minister, can you explain to me, after 20 years of promising national pharmacare, what you are waiting for?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I'm assuming that most members on the health committee have read my mandate letter. I'm going to quote from it:

Work with provinces and territories to: ...improve access to necessary prescription medications. This will include joining with provincial and territorial governments to negotiate common drug prices, reducing the cost Canadian governments pay for these drugs, making them more affordable for Canadians, and exploring the need for a national formulary....

When I had the opportunity and the privilege to meet with the ministers of health for the first ministers meeting, we were able to come up with a consensus that we all want to work on improving access to affordable medication for all Canadians. When we look at enhancing our health care system, we want to make sure that enhancing the affordability, the accessibility, and the appropriate use of prescriptions is absolutely mentioned in that.

[The Chair, Liberal, Bill Casey]

That's all we can handle.

Now we're going to go to Ms. Sidhu and I understand you're going to split your time with Ms. Ludwig.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Minister, for being here today.

Earlier this week, your officials were here, and we talked about the food guide and working on a healthy eating strategy. This is a very important issue. On the healthy eating strategy, how can we improve the health of Canadians? The obesity rate is getting high. How can we decrease obesity rates, especially in our youth?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much for the question.

Another portfolio that I became quickly briefed on and versed in is our healthy eating strategy. As probably many of you are aware, last year the previous minister of health, Minister Philpott, launched the healthy eating strategy. Certainly some progress has already been made with respect to work that needs to be done.

When I look at the healthy eating strategy, I really look at three pillars, three areas in which work needs to be done. The first one is Canada's food guide, which I believe is the one you guys are studying right now. Another one is marketing to kids, and the third one would be front-of-pack labelling.

We recognize that as Canadians we are facing an obesity crisis, really and truly. One in three children are either overweight or obese. Two out of three Canadians are either overweight or obese. We recognize that what we eat certainly contributes to the chronic health crisis that we're faced with, as well as the level of chronic disease in our country.

We also recognize that as a government we're spending over $26.7 billion a year when it comes to chronic health conditions in this country, so work needs to be done.

With respect to our healthy eating strategy, we recognize that it's not the only avenue that will help address this health crisis, but it's certainly a step in the right direction.

When we look at the issue of Canada's food guide, I'm really excited to see the review that's under way right now, and I'm really looking forward to the results of the study you guys are doing, as well. We recognize that Canada's food guide is a bit dated now, but it's certainly a document that many Canadians use because it's the second most requested document from Canadians, so we certainly know that people still feel the value of having Canada's food guide.

What I would say is that we certainly have to make sure that our food guide is modernized and up to date. We live in a multicultural country right now, and there are many different diets out there, so it's really important to make sure the research is done. For Canada's food guide, I really see it as a model to be able to tell Canadians not what to eat but the types of things they can eat to get the nutrients they need. At the end of the day, that's really what the new version of the food guide is going to be all about.

With respect to the food guide, that's really the work that's being done there and I'm very pleased that the department, hopefully by mid-2018, will be able to give an update as to where we're at there.

[Sonia Sidhu, Liberal, Brampton South, ON]

Canada has a large population of seniors with varying health needs. I'm happy with the investment made in home care across Canada. Could you tell me what impact this has had and how else we are helping to support the health of seniors across Canada?

What steps are we taking to improve the health of seniors? Are we taking any more steps for an innovative health system? Can you tell me about that?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

We've certainly heard loud and clear, when negotiations were under way last year about the health transfer payments, that when it came to seniors, long-term care services, mental health, and palliative care, they're certainly priority areas that Canadians are absolutely concerned about.

We were pleased to be able to provide some funding for providing home support care services to provinces and territories to allow them to really develop services and models that work best in their provinces and territories. We certainly don't want to have a top-down approach and tell them what to do, but if we can provide them with funding, then from there they can put in place what best meets their needs in that area.

We also recognize that seniors want to live longer in their homes, and we really have to make sure that the appropriate services are put there. Many of those responsibilities fall under the provinces and the territories, but providing additional funding for health care transfers can certainly help them and help the provinces and territories take the steps they need to effectively deal with the growing aging population we have.

[The Chair, Liberal, Bill Casey]

Okay, we now go to Ms. Ludwig.

[Karen Ludwig, Liberal, New Brunswick Southwest, NB]

Thank you, Madam Minister, for being here today.

I actually have two questions. I'll give them to you up front. The first one is following my colleague's question on healthy eating. I'm wondering how much funding will be devoted to public awareness and education regarding the healthy eating strategy on an annual basis.

The second one is about Lyme disease. I was truly surprised this summer, after the federal government and the Province of New Brunswick partnered on the surveillance program, how little money it actually took to get results regarding identifying broader endemic areas. I'm wondering if you could also please describe the activities and incentives the Public Health Agency of Canada intends to undertake to raise public awareness and support education regarding Lyme disease, particularly in endemic areas.

Those are my two questions. Thank you.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you very much, Ms. Ludwig.

With respect to the area of public education around our healthy eating strategy, no specific amount has been identified yet, but I can tell you that through the many consultations I've had with many of my caucus colleagues—actually, not just caucus but members of Parliament from all parties—and also hearing from many Canadians, we certainly know that providing tools for Canadians to make sure they can make informed decisions is very important.

We've also heard that the education component is very important. That is certainly something that we are prepared to look into when we look at our rollout of the strategy, making sure that some services are put in place there.

With respect to the issue of Lyme disease—I know that's a passionate area of yours—I may ask Dr. Tam to provide a bit of an update as to where we're at with respect to the surveillance results.

[Dr. Theresa Tam]

Public awareness and detection of Lyme disease is a really important aspect of the federal framework. As you've said, it may not cost very much, but you can actually do quite a bit by looking for positive ticks, for example, in the community and by partnering with different organizations, whether they be Parks Canada, family physicians on the front line, or patient groups. There have been some very good examples—you've just cited one of them—where partnerships really worked. In Ontario and Manitoba, Lyme patient groups said that has worked really well for them—how they've been engaged to increase public awareness of this growing issue.

At the Public Health Agency, we've been doing enhanced surveillance activities and also projections in climate data so that we can actually see where the frontier of Lyme disease is pushing into different areas of Canada. I believe that with this further funding support we'll continue to improve on awareness campaigns.

[The Chair, Liberal, Bill Casey]

Your time is up.

Now we're going to go to our five-minute round.

I have to say that we're a little long-winded today, so if you could all tighten up your questions and your answers, we'll all get another kick at the questions.

We've all been over.